Earlier this year, both the Illinois House and Senate passed SB 904, a bill that made changes related to the payment of medical services under the Workers’ Compensation Act. The major change was related to the charging of interest for unpaid medical bills by allowing medical providers to go to Circuit Court to obtain relief (payment). It was sent to Governor Bruce Rauner for signature. On August 29, 2018, Governor Rauner issued an amendatory veto. He stated that SB 904 was a “huge setback for the medical community,employers and injured workers.”
The legislature was not done. After negotiations with the Illinois Chamber of Commerce, the Senate voted to override Governor Rauner’s veto of SB 904, 55-1. Again, on November 27, 2018, the Illinois House overrode the Governor’s amendatory veto of SB904 by a vote of 110-2-0. The overrides having received the constitutional majority, SB 904 became law. The bills, in their final iteration, will amend the workers’ compensation act as follows:
- Allows medical providers to go to circuit court for collection of the 1% interest penalty if the medical bill is not paid within 30 days
- Requires insurance providers to issue an Explanation of Benefits if the claim does not contain substantially all of the required data elements necessary to adjudicate the bill or the claim is denied for any other reason.
The final changes substantially limited the sweeping authority created in the initial SB 904. Medical providers will only be allowed to seek Circuit Court relief for the payment of interest, and not for the payment of the actual medical bill. The Illinois Workers’ Compensation Commission will continue to have jurisdiction to adjudicate the medical benefits and bills pursuant to Sections 8.2, 16, and 19 of the Act. Given this change, Circuit Court relief will likely only be sought in situations (large unpaid medical bills and/or a lengthy period of non-payment) that incur a significant amount of interest to justify the expense of seeking relief in Circuit Court.
Finally, this change does not affect the payment of medical bills in disputed claims as long as an Explanation of Benefits is issued.
These are obviously major changes to the Act. If you have any questions as to how this could impact the handling of claims, please do not hesitate to contact us. Thanks to Attorney Frank Johnston of our Champaign office for this important summary of the new changes.